To the Editor: Since the initiation of multidrug therapy for leprosy (Hansen disease) in the 1980s by using rifampin, dapsone, and clofazimine, resistance to rifampin and dapsone has been observed worldwide and is still prevalent (1,2).

Since the 2004 US Food and Drug Administration designation of clofazimine as an investigational drug, any patients with multibacillary disease are likely to have been reported so they would be able to receive the recommended MDT, although paucibacillary disease may be underreported.

Because of the multibacillary load and higher risk for immune reactions and pigmentation, especially with clofazimine or minocycline, we prescribed clarithromycin, rifampin, and dapsone for this patient.

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